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When Redness Makes You Blue

Posted: 04/02/2012

While rosacea has become increasingly recognized as a common and conspicuous red-faced disorder, mounting evidence has shown that it can cause far more emotional stress and physical pain than previously known. April has been designated as Rosacea Awareness Month by the National Rosacea Society (NRS) to alert the public to the warning signs of this chronic and often progressive condition now estimated to affect more than 16 million Americans.

“Emotional stress frequently exacerbates or induces rosacea symptoms, creating a tailspin for many patients,” said Dr. Richard Granstein, chairman of dermatology at Cornell University. “Combine this with the physical discomforts and the social impact of the disorder, and there are many aspects of rosacea that go well beyond its effects on personal appearance alone.”

Rosacea usually first strikes individuals between the ages of 30 and 60, and may initially resemble a simple sunburn or an inexplicable blush. Suddenly, without warning, a flush comes to their cheeks, nose, chin or forehead. Then just when they start to feel concerned, the redness disappears.

Unfortunately, it happens again and again, becoming ruddier and lasting longer each time — and eventually visible blood vessels may appear. Without treatment, bumps and pimples often develop, growing more extensive over time, and burning, itching and stinging are common.

In severe cases, especially in men, the nose may become enlarged from the development of excess tissue. This is the condition that gave comedian W.C. Fields his trademark red, bulbous nose. In some people the eyes are also affected, feeling irritated and appearing watery or bloodshot. Severe cases of this condition, known as ocular rosacea, can result in reduced visual acuity.

Among the most famous rosacea sufferers is former President Bill Clinton, whose doctors disclosed that he has this condition in The New York Times. Others reported to have suffered from the disorder include Princess Diana, financier J.P. Morgan and the Dutch painter Rembrandt.

In new NRS surveys, 69 percent of rosacea patients said they experienced a flare-up related to emotional stress at least once a month, and more than 90 percent of the respondents said they had suffered some form of physical pain from their condition. A burning sensation was the most commonly reported discomfort, named by 75 percent, followed by itching, cited by 65 percent, and stinging, mentioned by 62 percent. Other types of pain associated with rosacea included swelling (44 percent), tightness (42 percent), tenderness (40 percent), tingling (31 percent), prickling (23 percent) and headache (20 percent).

Perhaps even more ravaging than its physical effects, rosacea often inflicts significant damage to people’s emotional, social and professional lives.

"It would be hard to invent a more embarrassing disease than rosacea," said Dr. Ted Grossbart, a psychologist at Harvard Medical School. "It affects the one part of the body that cannot be hidden — the face — and tends to strike people at a time in life when they may be increasingly self-conscious about changes in their appearance. Moreover, especially because this condition is not widely understood, it can leave its victims feeling isolated and even alienated from society."

In National Rosacea Society surveys of more than 1,200 rosacea patients, 76 percent said rosacea's effect on their facial appearance had lowered their self-confidence and self esteem. Sixty-nine percent of the survey respondents said they had experienced embarrassment as a result of the disorder, and nearly 63 percent reported difficulty in establishing new relationships. Forty-one percent said they had avoided or canceled face-to-face contact because of their condition, and 58 percent said the effect of untreated rosacea on their appearance had made them the subject of stares, misconceptions, rude comments or jokes.

Eighty-eight percent of those with severe symptoms said this disorder had affected their professional interactions, and nearly 51 percent reported they had missed work because of their condition. Thirty-nine percent said it might even have prevented them from being chosen for a new job.

Adding insult to injury is a common myth that rosacea sufferers, who often have a red face and nose, may be heavy drinkers. In fact, while alcohol may aggravate rosacea, these symptoms can be just as severe in a teetotaler. Another common misconception is that rosacea is caused by poor hygiene, while in reality it is unrelated to personal cleanliness.

Although the cause of rosacea is unknown, a vast array of lifestyle and environmental factors can trigger flare-ups of signs and symptoms in various rosacea sufferers. Common rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, heavy exercise, alcohol, spicy foods, heated beverages, humidity, certain skin-care products and many others.

“While rosacea is a long-term disorder and there is no cure, the good news is that it can be effectively controlled with medical therapy and lifestyle modifications,” Dr. Granstein said. “This can substantially improve the quality of people’s lives.”

Individuals with any of the following warning signs of rosacea are urged to see a dermatologist for diagnosis and appropriate treatment:

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Our Mission

The National Rosacea Society is a 501(c)(3) nonprofit organization whose mission is to improve the lives of people with rosacea by raising awareness, providing public health information and supporting medical research on this widespread but little-known disorder. The information the Society provides should not be considered medical advice, nor is it intended to replace

consultation with a qualified physician. The Society does not evaluate, endorse or recommend any particular medications, products, equipment or treatments. Rosacea may vary substantially from one patient to another, and treatment must be tailored by a physician for each individual case. For more information, visit About Us.